Understanding PrEP and PEP: Prevention Strategies for HIV

What are PrEP and PEP?

PrEP (Pre-Exposure Prophylaxis) and PEP (Post-Exposure Prophylaxis) are both strategies used to prevent HIV infection, but they are used in different contexts.

PrEP is a preventive measure taken by individuals who are at high risk of contracting HIV. It involves taking a daily medication to lower the chances of getting infected if exposed to the virus.

PEP, on the other hand, is an emergency measure taken after a potential exposure to HIV. It involves taking a course of antiretroviral drugs as soon as possible, within 72 hours of exposure, to prevent the virus from taking hold.

When Should PrEP be Taken?

PrEP should be taken by individuals who are at ongoing risk of HIV infection. This includes:

• People in a sexual relationship with an HIV-positive partner.
• Individuals who do not consistently use condoms during sex with partners of unknown HIV status.
• People who share needles or other equipment to inject drugs.
• Those who have been diagnosed with a sexually transmitted infection (STI) in the last six months.

PrEP is taken as a daily pill, and it needs to be taken consistently for maximum effectiveness. It is recommended to start PrEP at least seven days before potential exposure to HIV and to continue taking it as long as the risk of exposure persists.

What is the Dosage of PrEP and PEP?

PrEP: The standard medication used for PrEP is a combination of two antiretroviral drugs: tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC), marketed as Truvada. The dosage is one pill taken once daily. Another option, Descovy (containing tenofovir alafenamide and emtricitabine), is also used but is approved only for men and transgender women.

PEP: The medication regimen for PEP typically includes three antiretroviral drugs taken over a 28-day course. A common regimen is tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) combined with either raltegravir (RAL) or dolutegravir (DTG). PEP must be started within 72 hours of potential exposure to HIV and is taken daily for 28 days.

What are the Precautions?

For PrEP:

• Before starting PrEP, an individual should have an HIV test to ensure they are HIV-negative.
• Regular follow-ups with a healthcare provider are essential to monitor kidney function and overall health.
• It is crucial to take the medication consistently every day for it to be effective.
• Continue to use other preventive measures such as condoms to provide additional protection against HIV and other STIs.

For PEP:

• PEP should be started as soon as possible, ideally within hours of exposure, and no later than 72 hours.
• It is essential to complete the full 28-day course of medication.
• Follow up with a healthcare provider for HIV testing and monitoring during and after completing the PEP regimen.

What are the Side Effects?

Both PrEP and PEP can have side effects, although not everyone experiences them, and they are usually mild.

PrEP:

• Common side effects include nausea, headache, and stomach pain.
• Some people may experience a temporary decrease in kidney function, which usually resolves after discontinuing the medication.
• Rarely, bone density may be affected, so regular monitoring is advised.

PEP:

• Side effects can include nausea, fatigue, diarrhea, and headaches.
• Some individuals may experience more severe reactions such as liver toxicity or kidney problems, so close monitoring by a healthcare provider is essential.
• PEP can also cause drug interactions, so it is important to inform the healthcare provider about any other medications being taken.

In conclusion, PrEP and PEP are effective strategies for preventing HIV infection when used correctly. PrEP is a daily pill for those at ongoing risk, while PEP is an emergency treatment started after potential exposure. Both require adherence to the prescribed regimen and regular medical follow-ups to ensure effectiveness and monitor for side effects. By understanding and utilizing these preventive measures, individuals can significantly reduce their risk of HIV infection.